NGOs: In fight against HIV epidemic, we have been relying too much on EU funding
Estonia is being ravaged by an HIV epidemic, and nobody knows just how many people are infected by the virus. Non-governmental organizations that deal with HIV-positive people on a daily basis confirm that Estonia has been pinning its hopes too much on funding from the European Social Fund.
“Aktuaalne Kaamera” reported that the ambassadors from three countries, Great Britain, the United States, and Finland, recently submitted a joint appeal to the Constitutional Committe of the Estonian Parliament stating that Estonia must tackle the issue of HIV more seriously and take more effective action to combat its spread, and that in order to do this, a special study committee should be created.
Ambassadors coming together to speak out regarding the internal affairs of another country is not exactly an everyday occurrence, however, the British ambassador commented that there is nothing unusual about a joint appeal, and he is glad to see that their appeal has brought the focus back on the epidemic.
“The other ambassadors and I are constantly in touch with members of parliament regarding important issues,” said British ambassador Christopher Holtby. “As this seemed to be a burning issue, we decided it was time to take action, particularly because we are three countries that have long supported Estonia, and we would like to see continuing targeted action on this front.”
While the ambassador may be putting it mildly, NGOs dealing with HIV-positive individuals on a daily basis confirm that Estonia has been resting on its laurels and pinning its hopes too much on funding from the European Social Fund.
“In my opinion, this is a matter of national security, and of the survival of our people, and such matters should be dealt with by the government; that is what it is there for,” said Dmitri Semeni, a member of the Patients' Forum.
The politician heading the creation of the parliament's study committee, Vilja Toomast, recalls a similar committee operating successfully in 2004, when HIV spread across the entire country at an explosive rate. “We need a group who will once again focus for a time on this problem in different areas and help offer guidelines for action,” she said.
Supervision can be provided for the committee as well. As is often the case when making important decisions, the development of the committee has been bogged down by political differences of opinion, and the bill from the Constitutional Committee has yet to reach its second reading.
According to Toomast, the committee's work would cost approximately 50,000€ per year, but considering both the significance of HIV and the amount money budgeted for it, which is 15,000,000€ per year, she finds that it is necessary that the committee be formed. Per Toomast's assessment, the main problem can be divided into two categories: one is a matter of finances, and the other, the concern that creating one such committee could prompt others to find cause to create their own study committees for other issues. Toomast, however, does not agree that this would be a concern.
Currently, Estonia has neither a national strategy nor a corresponding government committee dedicated to the matter; exactly one person at the Ministry of Social Affairs is dealing with HIV prevention. However, a new strategy is currently being developed, which should be completed sometime during the spring.
The director of the Estonian Network of HIV-Positive People, Latsin Alijev, said that the previous national strategy concluded in the year 2015, and that to suggest that all is well now is a great exaggeration. “The problem will persist so long as we have people officially registered but not taking their medications,” he said.
There may be as many as 6,000 such HIV-positive people who refuse to medicate. According to Alijev, there are a number of different reasons why one may choose not to medicate, including fear, availability of medical treatment, the patient not feeling any symptoms, and indifference. Reaching such people and referring them to treatment is one of the keys to preventing the spread of HIV. Another is reaching those who do not yet know that they have been infected; their numbers may range from 6,000 to even 9,000 people.
The director of the Infectious Diseases and Drug Monitoring Department of the National Institute for Health Development (TAI), Kristi Rüütel, says that mass testing of the entire population wouldn't be necessary, however, they do need to idenfity those that belong to high-risk groups and provide them with the opportunity to get tested. She mentioned that family physicians could be of help in this case. All of this will require finances and skilled planning.
It is worth noting that HIV is increasingly spreading among the over-30 and heterosexual demographic in particular.